A review of the rollout of Australia's personally-controlled e-health record (PCEHR) system has recommended that the system sign up patients by default from 2015, unless they decide to opt out.

The review (PDF), which was commissioned by Health Minister Peter Dutton in November last year to examine the rollout of the AU$1 billion system and why so few patients and doctors have signed up to in the years since its launch.

Although the review was completed in December by UnitingCare Health group executive director Richard Royale, Australian Medical Association president Dr Steve Hambleton, and Australia Post's CIO Andrew Walduck, the minister has sat on the report for six months, and despite attempts to obtain the report under Freedom of Information, the department refused to release the report until today.

There were 38 recommendations made in the report, including renaming the PCEHR to the My Health Record (MyHR) to encourage more people to use the service. The system would become opt-out at the start of 2015, provided the government changes the records to include demographics, current medications, adverse events, discharge summaries, and clinical measurements.

Under the opt-out system, the report has recommended that patients should be advised via SMS when their record is opened or used by default.

As of 1 January 2015, patients who had not opted into the system would be provided with an unpopulated record available for use, and there would be an assumption for those who did not opt-out that there was standing consent for health records to be added to the system.

The review panel stated that the opt-out system would result in a wider take-up and would increase its value to health professionals.

It was also recommended that the National E-Health Transition Authority (NEHTA) should also be dissolved and replaced with the Australian Commission for Electronic Health (ACeH) with feedback provided from a number of committees established overseeing security, privacy, clinical advisory, and other matters.

The report recommended that all of the health record system operations should be centralised in the Department of Human Services. This would see DHS responsible for all infrastructure, maintenence, and contact centre operations. The remaining work involved in the e-health record system should be contracted out, the report stated.

The government has yet to announce its response to the report.

In the 2014 Budget, Dutton allocated AU$140.6 million to keep the e-health system going until the government acts on the recommendations of the review.